Acute Mountain Sickness

Acute Mountain Sickness:  Sick and Tired

 

 

There are a few times in my life that I find myself “sick and tired”.  For example, I am usually sick and tired of my kids leaving the lights on in the house after every one of them has gone to bed (I have 3 teenagers and a couple of ‘tween’agers so, go figure).  Although I never imagined I could get sick and tired of skiing, I found myself this weekend literally sick and tired.  For a while, I thought this was the new me in my forties and that I had to just suck it up.  But then I began to recognize the symptoms of high altitude pulmonary edema and I realized (thankfully) that this wasn’t the start of my midlife crisis, but rather a form of acute mountain sickness.

Acute mountain sickness, also known as altitude sickness or “the altitude bends” is an illness that most commonly occurs at altitudes above 8000 ft.  It is the physiologic consequence of decreasing consecration of oxygen and lower air pressure that occurs at higher altitudes.  You would think living at 7200 ft. in Laramie your body would acclimate to these effects but if you are a skier, climber or otherwise rapidly ascend and undergo significant physical exertion to get there, you are at risk.

Its symptoms for most are like mine, mild; however if allowed to progress, it can become very serious or even fatal.  Most people will experience fatigue, headache, mild nausea or loss of appetite but you may also experience difficulty sleeping, dizziness or vomiting.  When combined with physical exertion, such as downhill skiing, symptoms may advance to shortness of breath, rapid pulse, a dry cough and chest tightness.  This occurs as fluid accumulates within the tissues of the lung and eventually you begin coughing up blood.  You may notice this as a metallic taste to your cough, as I did.  As the disease progresses, fluid accumulates in the tissues of the brain (called cerebral edema) bringing on worsening headaches, confusion, altered consciousness and incoordination.  The combination of these fluid shifts at their worst can lead to death.

                Treatment fortunately is very simple:  descend to a lower altitude.  Symptoms usually abate quickly over a few days.  For the extreme problems there are appropriate medications and supportive therapy.  The best treatment is of course prevention.  In my case, better physical conditioning before would have slowed progression.  Ascending slowly, sleeping at lower altitudes or even acclimating a day or two every 2000 ft. during your ascent will help.  If you anticipate having difficulty, your physician may prescribe you a medication to take during your trip that will help prevent those fluid shifts.  If you have heart or lung disease you should avoid high altitudes.

 

Christmas Day 2008

The star of the show this year is a cute little addition to our family (as if 5 kids isn't enough). Santa brought the kids a little "yorkie-poo" puppy. We haven't decided what to name her yet but everyone is having fun getting to know her.

McKenna with the pooch.

The kids had a good christmas and mom & dad were left sitting in the mess while everyone played with all their toys, ate their candy, and just relaxed.

Cooper had a blast getting a race track with cars and some model mortorcycles. Now he has his own motorcycle like his dad.

Racing cars. Awesome!!!!... "yeah, awesome"

Christmas Eve 2008

For Christmas Eve dinner this year, we tried our hand again with prime rib. Travis experimented again with a salt shell. As you can see, it makes for a very wintery presentation! It consists of a 5 lb rib eye roast and a 3 lb box of Mortons salt rock mixed with water to make a thick paste. This is then molded around the roast like a skilled artist works with clay. I sprayed it down with a spray bottle also to keep it moist and to assist with forming the salt around the meat. The meat I prepared with a cracked pepper rub and worchestershire sauce.

Carefully packing the salt around the meat is not as easy as it looks. Everytime you push against the meat, it flexes and then the salt you worked on falls off the sides. It can be very frustrating! The extra water helps though.

As you can see here, the final product looks pretty good. The salt seals the juces in suprisingly doesn't impart a salty flavor to the meat. You don't even have to cover the pan as the salt shell serves as a mini oven. The best part though, is the eating...

Ahhh, a perfect medium rare. As you can see, there is turkey there too. Well... Josh and Amanda and the girls came over to share dinner. We all had a nice feast and then played some gift exchange games. It was a lot of fun. See the pics below.

Well it's Christmas time and we managed to find a few decorations to put up in our temporary home. We were all so happy at how much better it feels in our home with a few decorations. It's exactly why we all love this time of the year.

The kids have found a lot of fun in the snow. Fortunately our home is built up on a hill and so we have an instant sledding hill built right in.

McKenna and Cooper ready for their turn down the hill.

Cool man Preston finishing his ride!

Newspaper Gyno

Here is another article that ran in the paper this past Sunday:

When Weight Loss Fails, Your Ovaries May Carry Some Blame...

If you ever watch late night television, beyond say 11:30 pm, you will undoubtedly be exposed to advertising about weight loss. American’s have become obsessed with their weight, and rightly so. Obesity, defined as a body mass index (BMI) of 30 or greater, affects approximately one-third of U.S. women today. Obesity is associated with a myriad of health problems, but for women, there are unique issues such as infertility and menstrual irregularities.
Besides being the source of big business, trying to lose weight for many women, can be a frustrating and discouraging uphill battle. When weight loss fails, women should turn to their physicians for help. That’s because the cause of obesity is a mix of environmental and genetic factors. Any reasonable person will admit the simplicity of weight gain: consume more calories than you use and you will gain weight. The complexity of our individual bodies however, makes that equation seem as difficult to solve as e = mc2! Queue the physician.
Making a conscious real lifestyle change toward eating a balanced, portion controlled diet and regular exercise are the foundation for weight loss. Nevertheless, there may be hormonal reasons why you struggle to lose those pounds. Many obese women have a condition known as “polycystic ovarian syndrome” (PCOS) that affects their weight management. Women with PCOS frequently experience irregular menses, infertility, and hair growth in places like the face, chest or abdomen. PCOS is caused by an overproduction or misuse of hormones like insulin, which makes losing weight more difficult, and male sex hormones called androgens which cause excess hair growth and acne. The condition tends to worsen as weight increases making it even more difficult to lose weight, thereby creating a vicious cycle of obesity.
PCOS is suspected in all women who have irregular menstrual cycles and physical signs of excess hair growth. It is diagnosed by history and exam primarily and by excluding other medical conditions. An ultrasound of your pelvis may reveal multiple small cysts on your ovaries which is where the condition gets its name (polycystic = many cysts). Obesity is not part of the diagnostic criteria, although it is frequently an observed consequence. In addition to the problems mentioned above, women with PCOS have an increased risk of developing type II diabetes later in life, heart disease, and high blood pressure.
PCOS is a lifelong condition but can be managed in a number of ways. Birth control pills will help control periods and unwanted hair growth which can then be removed by a variety of technologies. As little as a 10% weight reduction can improve the condition, making it easier to continue losing weight. Studies done with “insulin-sensitizing” agents (such as metformin) also show improved weight loss ability, improved fertility, and a reduction in the risk of diabetes. Ultimately, coordination with your gynecologist and an endocrinologist may be necessary to find the best management strategy for you.
As for weight loss programs out there, anything that encourages you to eat a balanced diet and control your portions while maintaining regular exercise is a sound program. Also, expect slow steady results. A healthy weight loss is 2-6 pounds per month. If, however, you find you still struggle, remember to blame your ovaries and see your doctor for help.
If you need additional information about treatments for obesity or PCOS, ask your physician, or contact Dr. Klingler or any of the qualified physicians of Laramie Physicians for Women at 307-745-8991.

The Christmas Tree

Our family was hard at work today decorating for Christmas. The kids have been dying to get the tree out and for things to look like the holidays again. Kris and I haven't been too motivated however, due to the fact that we don't know where anything is over here since the move. But, we managed to find most of it and it's begining to look a lot like Christmas now. All I can say is, "thank heavens for pre-lit trees!" --TK

Newspaper Gyno

As part of my contribution to the community, I recently began publishing a column for the local newspaper featuring topics on women's health. It's been fun. So, I thought I would publish them here for your information. Enjoy...

New Hope for Women with Painful, Heavy Menstrual Periods

Every year about 650,000 American women undergo a hysterectomy. This surgical procedure involves removing a woman’s uterus, and sometimes her ovaries and cervix. For many women, this procedure provides much sought-after relief from a variety of medical problems, including severe pain and heavy or prolonged periods.
However, a hysterectomy is major surgery, with a significant recovery period and potential complications. It should only be considered when all other options have been exhausted. Fortunately, there are now more options than ever for women suffering from painful, heavy periods. These options range from less invasive surgical procedures to long-term drug therapy. Determining what is appropriate for you requires a careful medical workup by an experienced and qualified gynecological surgeon.
One option now available, endometrial ablation, involves removal of the lining of the uterus - the source of bleeding during a menstrual period. For many women, this is a very effective solution, with up to 90% of women finding satisfactory relief of symptoms. After the procedure, most women report lighter or normal periods, and some have their periods stopped completely. One form of endometrial ablation, the new NovaSure procedure now available here in Laramie, has evolved to the point that it may be performed as a quick outpatient procedure that requires no incisions, uses only local anesthetic, and generally takes less then 15 minutes to perform. NovaSure uses precisely measured electrical energy, delivered through a slender, hand-held device, to remove the endometrial lining. Prior to recommending this procedure, however, it is important that your physician determine that you are an appropriate candidate, with a good likelihood of success. Your physician will take a complete medical history, and perform a physical exam. Other tests may include some blood tests, perhaps a biopsy (tissue sample) of the uterine lining, and possibly other more involved tests such as a hysteroscopy or ultrasonography. These tests can usually be done in your physician’s office, and are quick and fairly painless.
NovaSure (like all uterine ablation procedures) is only appropriate for pre-menopausal women with heavy menstrual bleeding, who are no longer interested in getting pregnant. But if you fall into this group, endometrial ablation may present a safe, effective alternative to hysterectomy.
If you need additional information about endometrial ablation, ask your physician, or contact Dr. Klingler or any of the qualified physicians of Laramie Physicians for Women at 307-745-8991.